CAR T-cell therapy in pediatric oncology: From leukemia to emerging promise in Wilms tumor and solid malignancies

CAR T cell therapy represents an advanced immunotherapeutic modality in pediatric oncology, involving genetic modification of a patient's own T cells to recognize and destroy cancer cells, offering highly targeted and personalized treatment. Originating from immunotherapy research in the 1980s, first-generation CARs were developed in 1989–1993, followed by second-generation CARs in the early 2000s with enhanced efficacy. FDA approval led to its first pediatric use in 2013, achieving complete remission in a child with acute lymphoblastic leukemia (ALL) [1–3].